Abstract
Due to considerable numbers of migrants from Chagas disease-endemic countries living in Catalonia, the Catalonian Health Department has recently implemented a screening programme for preventing congenital transmission, targeting Latin American pregnant women who attend antenatal consultations. Diagnosis of Trypanosoma cruzi infection in women is based on two positive serological tests. Screening of newborns from mothers with positive serology is based on a parasitological test during the first 48 hours of life and/or conventional serological analysis at the age of nine months. If either of these tests is positive, treatment with benznidazole is started following the World Health Organization's recommendations. The epidemiological surveillance of the programme is based on the Microbiological Reporting System of Catalonia, a well established network of laboratories. Once a positive case is reported, the responsible physician is asked to complete a structured epidemiological questionnaire. Clinical and demographic data are registered in the Voluntary Case Registry of Chagas Disease, a database administered by the Catalonian Health Department. It is expected that this programme will improve the understanding of the real burden of Chagas disease in the region. Furthermore, this initiative could encourage the implementation of similar programmes in other regions of Spain and even in other European countries.
Highlights
Due to migration flows the traditional epidemiological pattern of Chagas disease has dramatically changed during the past decades [1]
In this paper we describe this screening programme that was developed thanks to the collaboration between different Catalonian experts on Chagas disease and the World Health Organization (WHO) Department of Control of Neglected Tropical Diseases
The epidemiological surveillance of Chagas disease for the screening programme is based on the Microbiological Reporting System of Catalonia (MRSC)
Summary
Due to migration flows the traditional epidemiological pattern of Chagas disease has dramatically changed during the past decades [1]. The need for early detection and treatment of congenitally transmitted cases prompted the Catalonian Health Department to implement a systematic screening programme for Chagas disease among Latin American pregnant women and their children [18]. Given the lack of a widely accepted standard for serological diagnosis of chronic T. cruzi infected patients, the Pan American Health Organization (PAHO) recommends to perform the diagnosis with two serological assays performed in parallel [20] Within these limits, the 40 laboratories participating in the programme use their own testing algorithm for the screening pregnant women (Figure 1). The epidemiological surveillance of Chagas disease for the screening programme is based on the Microbiological Reporting System of Catalonia (MRSC) This is a collaborative network of Catalonian laboratories that has been collecting information from different pathogens of public health importance since 1993. The main goals of this surveillance system are to assess the implementation of the protocol in the region and to periodically report the results to health providers and public health authorities
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